Welcome to Guidelines for Nurses. This site uses cookies, some may have been set already. If you continue to use the site, we will assume you are happy to accept the cookies anyway. Read about our cookies here..

Key messages

People with care and support needs, such as older people or people with disabilities, are more likely to be abused or neglected. They may be seen as an easy target and may be less likely to identify abuse themselves or to report it. People with communication difficulties can be particularly at risk because they may not be able to alert others. Sometimes people may not even be aware that they are being abused, and this is especially likely if they have a cognitive impairment. Abusers may try to prevent access to the person they abuse

Many aspects of keeping people safe from abuse are complex, and it is important that they are fully understood

Signs of abuse can often be difficult to detect

Many types of abuse are also criminal offences and should be treated as such

Evidence of any one indicator from the following lists should not be taken on its own as proof that abuse is occurring. However, it should alert practitioners to make further assessments and to consider other associated factors

The lists of possible indicators and examples of behaviour are not exhaustive and people may be subject to a number of abuse types at the same time

Possible indicators of physical abuse

No explanation for injuries or inconsistency with the account of what happened

Injuries are inconsistent with the person’s lifestyle

Bruising, cuts, welts, burns, and/or marks on the body or loss of hair in clumps

Frequent injuries

Unexplained falls

Subdued or changed behaviour in the presence of a particular person

Signs of malnutrition

Failure to seek medical treatment or frequent changes of GP

Domestic violence or abuse

Types of domestic violence or abuse

Domestic violence or abuse can be characterised by any of the indicators of abuse outlined in this briefing relating to:

psychological

physical

sexual

financial

emotional

Domestic violence and abuse includes any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been, intimate partners or family members regardless of gender or sexuality. It also includes so called ’honour’-based violence, female genital mutilation and forced marriage.

Coercive or controlling behaviour is a core part of domestic violence. Coercive behaviour can include:

acts of assault, threats, humiliation and intimidation

harming, punishing, or frightening the person

isolating the person from sources of support

exploitation of resources or money

preventing the person from escaping abuse

regulating everyday behaviour

Possible indicators of domestic violence or abuse

Low self-esteem

Feeling that the abuse is their fault when it is not

Physical evidence of violence such as bruising, cuts, broken bones

Verbal abuse and humiliation in front of others

Fear of outside intervention

Damage to home or property

Isolation—not seeing friends and family

Limited access to money

Sexual abuse

Types of sexual abuse

Rape, attempted rape or sexual assault

Inappropriate touch anywhere

Non-consensual masturbation of either or both persons

Non-consensual sexual penetration or attempted penetration of the vagina, anus, or mouth